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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE(-. PLETED FOR APPLICATION TO BE ACCEF Date: �(;ANNED Permit Number:.1(Q0(n • r gy RECEIVE® J w St. Lucie county © � '� JUN 0 6 2016 Building Permit Application Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County. FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III Address: la7 .5 Legal Description: Property Tax ID #: LAI- 13e Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: jLetalac) r% q* 9ar�e o(0ol5, Ll kP -F't N kP tc4-CA-�05 Wnf`F I M23`118 + IZ380 Gas Tank Plumbing Total Sq. Ft of Construction: Cost of Construction: $`�3e9,y,aLi , rut -cnecKall apply: Piping Shutters ers " Generator S Ft. of First Floor: _ Utilities:Sewer ®Septic Lot No. Block No.' (DX? w- 4)c El'Wiridows/Doors ® Roof Building Height: C�WiERCESS�E` ,< ON 'A t 4 µ Name so slic.� V l '4, .ko =ssoc a, c, Name L.epe7 Address: IDLUCRo-1�n-�+sc.,e, asa.4 3wJ, ;.� r_ _ "Company: 1 s D`i LC 666aP J)oors Le-C City: PCT sr. l„csz State;;( ;..Address:;lbrl-_7', i50*'i1illilcih love. Zip Code: 3Y9170 Fax: 112A-33f State: -EL - Phone No. -7 7A- F 3 - 62zt'( Zip Code: -AIK3 Phone No. 77 Fax: N�ZA 70-$14 E-Mail: G(A Fill in fee simple Title Holder on next page (if different E-Mail:.1 oor / yrW �A%OD .Goy State or County License: issY3 from the Owner listed above) rz vaiue or construction is >z)uu or more, a KELURDED Notice or commencement is required. i �S(1PPE1VIiQi�SilUgfElyjAlilNDRlAT1QN� Y Ri tt ��i`� ' ,.x. .r.Ez..,:."3r`v�_'"�a-a i ._�.,.: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: ✓ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable _ BONDING COMPANY: /Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is grariiing a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a fulliconcurrency review: room additions, accessory structures, swimming pools, fences; walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. -A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before _ Signature of Owner/ Lessee/Agent STATE OF FLORID9, , COUNTY OF c� h J� The for oing instrument was acknowledged before me this day of m� 20 Uaby r7Lln (Name of person acknowledging) Notary Public- State of Personally Known OR Produced Identification Type of Identification Produced IFS, bL Commission No.15 AM HEA7HERHMF Revised 07/15/2014 4 S Signatyfe of Contractor/License Holder STATEOF.FLORIDA ' COUNTY OF IJJCI, The forgoing instrument was acknowledged before me this day of A l l`` nn 20 Jja_ by A�CWr7 (NamLr6f person acknowledging) A n (Signature of Notary Public- State Personally Known OR Produced Identification ✓ Type of Identification Produced KAREN S. NIEL5EN Commission N FF 115637 June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW • REVIEW REV W REVIEW REVIEW REVIEW DATE COMPLETE /{, INITIALS ®r